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ICU mortality

A Hernández, G Yagüe, E García Vázquez, M Simón, L Moreno Parrado, M Canteras, J Gómez
OBJECTIVE: Pseudomonas aeruginosa is one of the major pathogens causing hospital-acquired infections. In recent years, antimicrobial resistance is increasing and multidrug resistant (MDR) and extremely drug resistant (XDR) isolates have been associated with an increase of mortality. The aim of this study is to assess the clinical significance and analyze predictors and prognostic factors. METHODS: Prospective case-control non-paired study involving 64 patients with P...
March 21, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Szu-Huei Su, Li-Min Wu
BACKGROUND: The severity of diseases and high mortality rates that typify the intensive care unit often make it difficult for surrogate decision makers to make decisions for critically ill patients regarding whether to continue medical treatments or to accept palliative care. PURPOSE: To explore the behavioral intentions that underlie the medical decisions of surrogate decision makers of critically ill patients and the related factors. METHODS: A cross-sectional, correlation study design was used...
April 2018: Hu Li za Zhi the Journal of Nursing
Fabienne D Simonis, Carmen S V Barbas, Antonio Artigas-Raventós, Jaume Canet, Rogier M Determann, James Anstey, Goran Hedenstierna, Sabrine N T Hemmes, Greet Hermans, Michael Hiesmayr, Markus W Hollmann, Samir Jaber, Ignacio Martin-Loeches, Gary H Mills, Rupert M Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Roger Smith, Tanja A Treschan, Edda M Tschernko, Marcos F Vidal Melo, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, Ary Serpa Neto
BACKGROUND: The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated with outcome of these patients. METHODS: The PRoVENT was an international, multicenter, prospective cohort study of consecutive patients under invasive mechanical ventilatory support. A predefined secondary analysis was to examine factors associated with mortality...
March 21, 2018: Annals of Intensive Care
Hye Yeon Yi, Soo Young Jeong, Soo Hyun Kim, Yoomin Kim, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh, Jong-Hwa Kim
Objective: Reviewing indications and characteristics of obstetric patients admitted to the intensive care unit (ICU) of a tertiary care center, comparing those patients by time period and place of delivery, and to verify clinical utility of acute physiology and chronic health evaluation (APACHE) II score in ICU-admitted women. Methods: Retrospective analyses were carried out for parturients admitted to the ICU of our institution from 1994 to 2015. Clinical characteristics were compared between time period (period 1: 1994-2004; period 2: 2005-2015) and place of delivery (our institution and local hospitals)...
March 2018: Obstetrics & Gynecology Science
Huang-Kai Kao, Charles Yuen Yung Loh, Hao-Wei Kou, Kuo-Chin Kao, Han-Chung Hu, Chia-Ming Chang, Chia-Hui Lee, Hsiang-Hao Hsu
BACKGROUND: Majority of current research focuses on pre-hospital care in mass casualty incidents (MCI) whereas this study is the first to examine multifactorial aspects of intensive care unit (ICU) resource management during a surge in massive burn injury (MBI) patients whilst identifying key outcome predictors that resulted in successful disaster managements. METHODS: Both critical care, surgical parameters and cost-effectiveness are investigated in patients admitted with severe burns resulting from the explosion...
March 18, 2018: Burns: Journal of the International Society for Burn Injuries
Santhi Iyer Kumar, Kathleen Doo, Julie Sottilo-Brammeier, Christianne Lane, Janice M Liebler
BACKGROUND: Studies exploring the effect of body mass index (BMI) on outcomes in the intensive care unit (ICU) have yielded mixed results, with few studies assessing patients at the extremes of obesity. We sought to understand the clinical characteristics and outcomes of patients with super obesity (BMI > 50 kg/m2 ) as compared to morbid obesity (BMI > 40 kg/m2 ) and obesity (BMI > 30 kg/m2 ). METHODS: A retrospective review of patients admitted to the Los Angeles County + University of Southern California medical intensive care unit (MICU) service between 2008 and 2013 was performed...
January 1, 2018: Journal of Intensive Care Medicine
Li Dong, Yi-Kun Kang, Xiang-Guang An
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) is one of the standard treatments for coronary artery disease (CAD) while hybrid coronary revascularization (HCR) represents an evolving revascularization strategy. However, the difference in outcomes between them remains unclear. OBJECTIVE: We performed a meta-analysis to compare the short-term and mid-term outcomes of HCR versus OPCAB for the treatment of multivessel or left main CAD. METHODS: We searched the PubMed, EMBASE, Web of Science and Cochrane databases to identify related studies and a routine meta-analysis was conducted...
March 19, 2018: Arquivos Brasileiros de Cardiologia
Nadine Musallam, Diana Altshuler, Cristian Merchan, Bishoy Zakhary, Caitlin Aberle, John Papadopoulos
BACKGROUND: There is little data guiding clinicians on how to discontinue vasopressors among septic shock patients on concomitant norepinephrine (NE) and vasopressin (VP). OBJECTIVE: To determine the incidence of hypotension within 24 hours of discontinuing NE (NE DC first) versus VP (VP DC first) first in septic shock patients. METHODS: This retrospective study evaluated septic shock patients admitted to the medical intensive care unit (MICU) and surgical ICU (SICU) receiving concomitant NE and VP...
March 1, 2018: Annals of Pharmacotherapy
Duygu Ferek Emir, Ibrahim Ulas Ozturan, Serkan Yilmaz
INTRODUCTION: Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. CASE REPORT: A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention...
March 13, 2018: American Journal of Emergency Medicine
Lauren E Ferrante, Margaret A Pisani, Terrence E Murphy, Evelyne A Gahbauer, Linda S Leo-Summers, Thomas M Gill
BACKGROUND: Frailty is a strong indicator of vulnerability among older persons, but its association with ICU outcomes has not been evaluated prospectively (i.e., with objective measurements obtained prior to ICU admission). Our objective was to prospectively evaluate the relationship between frailty and post-ICU disability, incident nursing home (NH) admission, and death. METHODS: The parent cohort included 754 adults aged ≥70, who were evaluated monthly for disability in 13 functional activities and every 18 months for frailty (1998-2014)...
March 17, 2018: Chest
J Marin-Corral, C Climent, R Muñoz, M Samper, I Dot, C Vilà, J R Masclans, A Rodriguez, I Martin-Loeches, F Álvarez-Lerma
OBJECTIVES: To evaluate the impact of the recommendations of the SEMICYUC (2012) on severe influenza A. DESIGN: A prospective multicenter observational study was carried out. SETTING: ICU. PATIENTS: Patients infected with severe influenza A (H1N1) from the GETGAG/SEMICYUC registry. INTERVENTIONS: Analysis of 2 groups according to the epidemic period of the diagnosis (2009-2011; 2013-2015). VARIABLES: Demographic, temporal, comorbidities, severity, treatments, mortality, late diagnosis and place of acquisition...
March 17, 2018: Medicina Intensiva
Piotr Czempik, Daniel Cieśla, Piotr Knapik, Łukasz Krzych
BACKGROUND: Acute kidney injury (AKI) in critically ill patients has a deleterious impact on the prognosis, especially when renal replacement therapy (RRT) is required. This issue has not yet been investigated in the intensive care setting in Poland. OBJECTIVES: The aim of the study was to evaluate the short-term outcomes of AKI-RRT subjects, based on a large registry population. MATERIAL AND METHODS: This observational multicenter study covered 100 demographic and clinical variables from the Silesian Registry of ICUs regarding 15,030 adult patients hospitalized between October 2011 and December 2014...
March 16, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Daisy Sanchez, Derek Dubay, Baliga Prabhakar, David J Taber
INTRODUCTION: To improve kidney transplant allocation equitability, a new Kidney Allocation System (KAS) was implemented December 4, 2014. The purpose of this study was to determine if the impact of KAS on peri-operative outcomes differed by recipient race/ethnicity. METHODS: This was a time series analysis using data aggregated in monthly intervals from October 2012 through September 2015 using the University HealthSystem Consortium (UHC). This includes national data aggregated at the center level of all US kidney transplant centers that participate in the UHC (416 centers)...
March 19, 2018: Journal of Racial and Ethnic Health Disparities
Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere
BACKGROUND: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS: Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes...
March 19, 2018: World Journal of Surgery
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
Alessandro Russo, Simone Giuliano, Giancarlo Ceccarelli, Francesco Alessandri, Alessandra Giordano, Grazia Brunetti, Mario Venditti
Objectives: a significant cause of mortality in intensive care unit (ICU) is represented by multidrug-resistant (MDR) gram-negative bacteria, such as MDR Acinetobacter baumannii (MDR-AB) and Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp). Aim of the present study was the comparison of clinical features, therapy and outcome of patients who developed septic shock due to either MDR-AB or KPC-Kp. Methods: were retrospectively analyzed patients admitted to the intensive care unit (ICU) of a teaching hospital, from November 2010 to December 2015, who developed septic shock due to MDR-AB or KPC-Kp infection...
March 19, 2018: Antimicrobial Agents and Chemotherapy
Corey Joseph, Marie Garrubba, Julian A Smith, Angela Melder
Pulmonary artery catheters (PACs) were introduced in 1970. Since then, their use has steadily increased. However, there have been questions raised regarding their efficacy for multiple clinical scenarios. The purpose of this systematic review was to determine the safety and effectiveness of routine use of PACs post cardiac surgery on mortality, complications, days in intensive care unit, days in hospital, and costs in patients undergoing cardiac surgery, or patients who end up in an intensive care unit. METHODS: Medline, All EBM, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched using predetermined search terms...
February 21, 2018: Heart, Lung & Circulation
Jeremy W Cannon, Lucas P Neff, Heather F Pidcoke, James K Aden, Philip C Spinella, Michael A Johnson, Andrew P Cap, Matthew A Borgman
BACKGROUND: Hemostatic resuscitation principles have significantly changed adult trauma resuscitation over the past decade. Practice patterns in pediatric resuscitation likely have changed as well; however, this evolution has not been quantified. We evaluated pediatric resuscitation practices over time within a combat trauma system. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric patients (<18 years). Patients with burns, drowning, and missing injury severity score (ISS) were excluded...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Hayley B Gershengorn, Carri W Chan, Yunchao Xu, Hanxi Sun, Ronni Levy, Mor Armony, Michelle N Gong
OBJECTIVE: To understand the impact of adding a medical step-down unit (SDU) on patient outcomes and throughput in a medical intensive care unit (ICU). DESIGN: Retrospective cohort study. SETTING: Two academic tertiary care hospitals within the same health-care system. PATIENTS: Adults admitted to the medical ICU at either the control or intervention hospital from October 2013 to March 2014 (preintervention) and October 2014 to March 2015 (postintervention)...
January 1, 2018: Journal of Intensive Care Medicine
Craig M Lilly, Omar Badawi, Xinggang Liu, Gill Christine S, Ilene Harris
OBJECTIVE: To determine whether patients transfused red blood cell (RBC) products according to guideline-specified pretransfusion hemoglobin (Hb) concentrations or for other reasons were more likely to survive their intensive care unit (ICU) stay. DESIGN: An observational study of 375 478 episodes of ICU care, over 5 years, was performed with ICU survival as the primary outcome. Outcomes were analyzed as a function of pretransfusion Hb concentration for groups with distinct transfusion indications while adjusting for potential confounders...
January 1, 2018: Journal of Intensive Care Medicine
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